Using the Built Environment, Building, Statues and Places, with PwD
PwD have a special relationship with their built environment. Even if their perception of time and space has changed, they live in a world where relationships, objects and situations matter. PwD may not be able to speak about the meaning environments have, but a sense of meaning and importance remains in their lives.
Enabling those living with dementia to continue to enjoy and take part in arts appreciation and activity offers back a quality of life, as well as providing a social experience where carers and PwD are welcomed as equal participants together.
Why is it useful?
Dementia is lifechanging. Loss of memory leads to struggles with communication and language and changes in behaviour and can have a negative impact on a person’s core sense of self. This disease changes relationships with people, places, and things, and, potentially, can lead PwD and their carers to become isolated. Often, PwD stop participating in activities they previously enjoyed. These can include exploring, discovering, and connecting with heritage, which is an experience that plays an important part in how people view the places they live, how they feel and their quality of life.
Dementia-friendly heritage is not just about ‘being nice’, it is good business practice: ethically, financially and legally. It is about being accessible, inclusive and relevant to our existing and potential audiences.
Activities:
1. Using the Built Environment - Visiting Heritage or Cultural Sites (or other public places)

What will we gain?
The experience of a PwD tends to be overlooked in the design of built environments, parks and public spaces. Living with dementia should frame design. This involves seeing the world through the eyes of people living with dementia, or looking out from the inside.
The social benefits of becoming dementia-friendly built environments are as follows:
- Helping people to live well with dementia
- Helping people stay independent
- Improving accessibility for the whole community
- Reducing social isolation.
In comparison to other visitor attractions, PwD view heritage and cultural sites as ‘safe’ and familiar spaces. The key attributes they want from a day out are:
- an attractive day out: historic buildings, collections, parks or gardens
- a relaxed and uncrowded environment
- being looked after in a secure environment with clear boundaries and manned entrance/exit points provision of a café and good access to toilets
- places that prompt memories of the past.
ACTIVITY
Download the activity PDF:
Visiting heritage or cultural sites (or other public places).pdf
Using Heritage sites, old factories, living history museums, old workplaces, arrange a guided tour for PwD. You can consider visiting an open air museum.
What will we need?
- Read the Multisensory Museum document attached
- Practical Considerations: If there are mobility issues then accessibility is key to consider beforehand. If a planned venue is close by then you could always do a recce to check that it is suitable for your day out and meet the needs of the PwD. There are some general things you might want to look out for when making your choice of which museum to go to – including disabled parking, suitable toilet facilities, wheelchair access and that there are plenty of quiet places to rest or eat.
Points for Reflection
- What do they do in crowded, loud, or confusing situations? When you’re out with your older adult, how comfortable are they in public? If their behaviour can become uncontrolled or extreme in places like cafes, art galleries or museums then consider what approach you will take to manage the situation. Think about their typical reaction to crowded, loud or busy places.
- Does being in public settings make them upset, angry, overly tired, anxious, or scared? Or do they get upset when plans change suddenly?
- Comfort – PwD may have a sense of loss, causing anxiety and insecurity. They need an environment of comfort and empowerment.
- Attachment - PwD need to feel a sense of belonging.
- Inclusion- PwD can find it hard to be included in situations where others do not have the same impairment. Individualised care and physical settings help people feel they are part of a group.
- Identity - A PwD is unique. A person’s life-story should be built into all interactions in the care setting
- It's always worth checking the area before your outing, identify the shortest route, and check if your chosen location has:
- Adequate parking and dedicated disabled parking.
- Accessible toilets for people with disabilities
- Accessible paths (this does not always mean that they are wheelchair friendly)
- Suitable café or restaurant facilities
- Quiet places to eat or rest.
Resources
We are dementia friendly | Museum of London
Designing Museum Programmes for People with Dementia - MuseumNext
2. Arranging an Outing for a PwD that Includes Going Outdoors

What will we gain
Helping PwD – being part of the community and being able to continue with everyday tasks are important factors that help people to live well with dementia. Becoming a dementia-friendly arts venue means enabling people to carry on doing the things they want to do.
Helping people stay independent – PwD want to remain independent and live at home for as long as possible. Being supported by the venues they visit plays a big part in this.
Improving accessibility for the whole community – getting it right for customers with dementia means that others will benefit too, including older customers. Changes such as having clear signage, or providing a quiet space, will be appreciated by everyone.
Reducing social isolation – people living with and affected by dementia are often isolated from the wider community due to lack of understanding and stigma. For some customers, visiting arts venues is a vital way of alleviating loneliness.
What will we gain
Helping PwD – being part of the community and being able to continue with everyday tasks are important factors that help people to live well with dementia. Becoming a dementia-friendly arts venue means enabling people to carry on doing the things they want to do.
Helping people stay independent – PwD want to remain independent and live at home for as long as possible. Being supported by the venues they visit plays a big part in this.
Improving accessibility for the whole community – getting it right for customers with dementia means that others will benefit too, including older customers. Changes such as having clear signage, or providing a quiet space, will be appreciated by everyone.
Reducing social isolation – people living with and affected by dementia are often isolated from the wider community due to lack of understanding and stigma. For some customers, visiting arts venues is a vital way of alleviating loneliness.
ACTIVITY
Download the activity PDF:
Arranging an outing for a Person with dementia that includes going outdoors.pdf
Arrange an outing for a person that includes using public transport and going to local places they know - shop, park, pub, football ground. - a simplified trip out to places that may trigger memory.
What will we need?
Good preparation is key to any organised trip out you will need to understand the Key characteristics of a dementia-friendly environment:
- Familiar – functions of places and buildings made obvious, any changes are small scale and incremental;
- Legible – a hierarchy of street types, which are short and fairly narrow. Clear signage;
- Distinctive – including a variety of landmarks and a variety of practical features, e.g. trees and street furniture;
- Accessible – access to amenities such as shops, doctor’s, post offices and banks within easy, safe and comfortable walking distances (5-10 minutes). Obvious, easy to use entrances that conform to disabled access regulations;
- Comfortable – open space is well defined with public toilets, seating, shelter and good lighting. Background and traffic noise minimised through planting and fencing. Minimal street clutter;
- Safe – wide, flat and non-slip footpaths, avoid creating dark shadows or bright glare.
- Prepare the person with dementia for your visit in advance. People with dementia are not always friendly to sudden changes of environment and leaving their familiar space, the place where they feel safe, especially in advanced stages of dementia. Remind people often a few days before visiting outdoors that you want to make this visit and get their consent.
Points for Reflection
- Being out in nature and sharing activity outside is something which brings immediate benefits to people living with dementia and we believe is a crucial part of “living well”. The outdoors is the original multi-sensory environment and we don’t need to be taught or learn how to connect with it. It is free and on our doorstep our entire lives, regardless of where we live.
- As little as five minutes out in nature – often referred to as a “dose of nature” (Barton and Pretty, 2010) – can offer clear benefits for a wide variety of people including improved self-esteem and improved mood.
- Green exercise can enable those living with dementia to feel well and experience a “dampening down” or absence of their dementia-related symptoms. In fact, the simple act of walking is important for all of us to feel well, forget about our illnesses or troubles and remain active.
- Regular contact with nature and the outdoors, and the stimulation provided with each season, can help a PwD orientate themselves in time and place which is calming and can reduce confusion and frustration. It is also an ideal way that families can spend time together with their loved ones, reconnect and manage their own health and wellbeing.
- Make all travel options very obvious in your communications (bus route numbers, frequency, taxi numbers, etc.). Signpost people to accessible transport, work with local Community Transport and provide information on booking travel assistance. Be clear about the availability of onsite parking and any costs this might entail
- While outdoors, caregivers or accompanying relatives should be able to manage the person with dementia's emotions, reduce their stress, calm them down, reassure them and create a safe environment for them in case of negative emotions, anxiety, disorientation, and confusion arise.
- While outdoors, caregivers or accompanying relatives should be able to manage the person with dementia's emotions, reduce their stress, calm them down, reassure them and create a safe environment for them in case of negative emotions, anxiety, disorientation, and confusion arise.
- Some people living with dementia can find it difficult to process information, so simple and quiet places are good destinations for outings. Choose accessible outdoor spaces near your permanent residence or care day center that are not busy and noisy (avoid heavy traffic, honking horns, construction noise, loud talking and shouting). Avoid large crowds and noises as they can create lack of concentration, stress, insecurity, and disorientation in the PwD.
- Quiet and less visited places are often good as PwDcan approach them at their own pace.
- Travel outside of rush hours and, if you can, use Google Maps that tells you in advance of problems ahead and will find you another route.
- Avoid visiting popular places on weekends and in school holidays.
- The key is to find places and activities that are stimulating and don't involve too many challenges or options. Dementia can also affect concentration, so it's worth doing activities in short bursts. You don't need to plan a day full of different experiences, a few hours of activity are enough.
- Carers should be familiar with both the PwD and their life history and interests (place of birth, where they lived, family, jobs, major life events, preferred music, favorite places, hobbies, and habits) in order to be able to support a session in an open space using the surrounding environment.
- Activities can range from being guided around a park, a square, to a woodland walk.
- PwD can get tired and lose interest quickly, on a walk outdoors make sure you plan carefully which points of interest you will see (statues, parks, buildings) and make sure there are dementia-friendly places around to take a break. Such places might be a quiet café.
Resources
Traveling with Dementia: 6 Ways to Know If It Will Work – DailyCaring
Video: Walk Through Dementia - walking home
Video: Transit accessibility and challenges: Tips for people living with dementia
3. Exploring your House or Street as a way to Start a Conversation

What will we gain
Carefully planned walks in outdoor environments are valuable for PwD because they support independence and mobility, maximising abilities and wellbeing. At the same time, outdoor spaces, squares, building architecture, and statues can be used with care to trigger the memory of PwD, if and when they can be linked to important memories or to their daily life in the past. In these excursions, PwD should always be accompanied by a member of their family or their carer, in order to avoid or mitigate the problems that may arise from possible disorientation or from getting lost and wandering.
Activity
Download the activity PDF:
Exploring your house or street to start a conversation.pdf
Exploring one particular house or street but using it as a way of starting conversation ( rather than a whole neighborhood.) Getting conversation going - let's think about using the Space Place exercise adapted for dementia.
Your task will be to put together a conversation starter booklet
What will we need?
- Ask the person to use their imagination to describe the colour of their house
- Ask the person the material that was used to built their house (texture etc)
- What type of street did you live in (urban, country side, where there any trees, shops etc,.)
- You will need to use the book ‘Steps and tips for seeing “more than meets the eye” A Place is a Space Sketchbook’ to complete this activity
Points for Reflection
- Have objects at hand that can be picked up and touched and used to stimulate conversation. Develop a range of activities that stimulates all five senses: sight, sound, touch, taste and smell.
- A number of PwD will have some form of sensory impairment (such as sight loss, hearing loss or both). As this can create additional difficulties with communication, ensure your activity allows equal access for people with a sensory impairment to all dementia related services and support.
- Communicating with a person with memory loss can be difficult, but the right strategies can bridge the gap and foster a more fulfilling relationship between the patient and/or loved one. For caregivers—whether you're a professional or a family member caring for a loved one—it’s important to adopt a positive attitude to effectively communicate.
Resources
‘Steps and tips for seeing “more than meets the eye” A Place is a Space Sketchbook’ by David Powell
Video: Steps and tips for seeing “more than meets the eye” - A Place is a Space sketchbook
EDUCATOR NOTES
Dementia is a debilitating disease and, as a result, the built environment plays a major role in promoting or hindering the health and well-being of people living with dementia. PwD often experience difficulty with complex tasks, reduced visuospatial perception, reduced short-term memory, difficulty understanding spoken and written language, disorientation with time, place and people, apathy and withdrawal.
Over the last 30 years, studies have shown that dementia-friendly environments can significantly promote health and well-being (Marshall 2001; Fleming, Cookes & Sum 2008; Fleming & Purandare 2010). Davis et al (2009) define a dementia-friendly environment as “a cohesive system of support that recognises the experiences of the person with dementia and best provides assistance for the person to remain engaged in everyday life in a meaningful way” (Davis et al 2009).
Dementia-friendly environments are important in the care, support, health and well-being of PwD, allowing people to feel valued as an individual, independent and in an environment where they are safe and are provided a sense of normalcy and sustain a quality of life.
Remember built environment is very important:
- Flooring is important and can be a significant barrier to PwD, especially those who might be experiencing perceptual or spatial difficulties
- Avoid highly reflective and slippery floor surfaces – plain or very lightly mottled flooring is the ideal. Wherever possible, avoid changes in the colour of flooring, or even a contrasting floorstrip, as it can appear to some people as a barrier, or a change in depth
- Make sure each floor/level of your building is clearly signed – for example, level 1, level 2, the stairs and lifts so they are clear to see and easy to navigate around. Ways out of screens, toilets and rooms should be signed so PwD know which door to use
- Where possible have clear sightlines – a view across a room can help a PwD to leave a room or head for something they want to see next
- Is there space for people to leave mobility aids such as wheelchairs, walking frames or mobility scooters if needed?
GLAM PROFESSIONALS NOTES
Cultural institutions such as museums have an important role to play in dementia awareness and education. They can also serve as safe spaces and can run a variety of activities. Within museums, PwD can enjoy programmes tailored to their needs.
Information about onsite facilities is crucial in the decision-making of PwD and their carers, as to whether they will visit the heritage site. In several studies PwD, mention a ‘beautiful setting, nice gardens, historical interest and things to do’ as reasons to visit, but highlighted the importance of the practicalities of visiting including:
- getting to the site: public transportation, car and coach parking facilities (cost, distance to entrance, clear signage)
- getting around the site: clear and simple signage and maps (including pictures), walking distances, ramps/lifts, availability of mobility aids and seating, visible trained staff to support
- availability, location and quality of facilities: catering, retail, accessible toilets
- flexible ticketing or membership options: any available offers that support shorter, more frequent visiting
- Provide information about the programme in dementia-friendly formats: session outlines with timings and photos, specific access information for each activity, general information (map, suggested attire, contact details).
- Be open in your communications (social media, website) about any limitations of your dementia-friendly heritage offer. If it is only a trial, be clear about timescale and costs. Don’t hide information or allow colleagues to hide it because you may initially want to start small.
- Design opportunities for socialising and respite for both PwD and carers.
- Remember to be creative, informal and flexible in your approach to planning and delivering opportunities
- Conduct an audit of your heritage site with the auditing tool in the Dementia Friendly Business Guide to understand what barriers and challenges visitors with dementia might have, so you can inform your staff.
CARERS NOTES
According to the Alzheimer’s Association, in the early and even middle stages of the disease, a person may be able to function independently, despite memory lapses or forgetfulness. The signs and symptoms can be subtle – especially at the beginning – which can often make it difficult for others to identify.
The early-to-middle stages of the disease can last a decade or more, so many people are able to continue enjoying an active social life, including traveling, for multiple years, visiting museums, art galleries, going to the local cafe and having meaningful conversations.
Information about onsite facilities is crucial in the decision-making of PwD and their carers, as to whether they will visit the heritage site. Some of the the importance of the practicalities of visiting including:
- getting to the site: public transportation, car and coach parking facilities (cost, distance to entrance, clear signage)
- getting around the site: clear and simple signage and maps (including pictures), walking distances, ramps/lifts, availability of mobility aids and seating, visible trained staff to support
- availability, location and quality of facilities: catering, retail, accessible toilets
- flexible ticketing or membership options: any available offers that support shorter, more frequent visiting